Provider Demographics
NPI:1861494957
Name:LAWRENCE, COURTNEY N (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:N
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1954 E HOUSTON ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78202-2951
Mailing Address - Country:US
Mailing Address - Phone:210-576-0533
Mailing Address - Fax:210-266-4676
Practice Address - Street 1:4212 E SOUTHCROSS BLVD
Practice Address - Street 2:STE 150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3783
Practice Address - Country:US
Practice Address - Phone:210-337-2100
Practice Address - Fax:210-337-2242
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ0059208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF82269Medicare UPIN